A Case of Hemorrhagic Necrosis of Ectopic Liver Tissue within the Gallbladder Wall. HPB Surg. 2011;2011:389381. [PMID: 21860541 PMCID: PMC3155784 DOI: 10.1155/2011/389381]

Case Report: Ectopic Liver (Choristoma) Discovered During Laparoscopic Cholecystectomy

Patient: Male, 47-year-old

Final Diagnosis: Ectopic liver

Symptoms: Right upper quadrant pain

Medication:—

Clinical Procedure: —

Specialty: Surgery

Ectopic liver tissue (choristoma) on the gallbladder: A comprehensive literature review

BACKGROUND

Liver tissue situated outside the liver with a hepatic connection is usually called an accessory liver, and that without a connection to the mother liver, is called ectopic liver tissue.

AIM

To identify studies in the literature on ectopic liver tissue located on the gallbladder surface or mesentery.

METHODS

We present two patients and review published articles on ectopic liver tissue located on the gallbladder surface accessed via PubMed, MEDLINE, Google Scholar, and Google databases. Keywords used included accessory liver lobe, aberrant liver tissue, ectopic liver tissue, ectopic liver nodule, heterotopic liver tissue, hepatic choristoma, heterotopic liver tissue on the gallbladder, and ectopic liver tissue on the gallbladder. The search included articles published before June 2020 with no language restriction. Letters to the editor, case reports, review articles, original articles, and meeting presentations were included in the search. Articles or abstracts containing adequate information on age, sex, history of liver disease, preliminary diagnosis, radiologic tools, lesion size, surgical indication, surgical procedure, and histopathological features of ectopic liver tissue were included in the study.

RESULTS

A total of 72 articles involving 91 cases of ectopic liver tissue located on the gallbladder surface or mesentery were analyzed. Of these 91 patients, 62 were female and 25 were male (no gender available for 4 patients), and the age range was 5 d to 91 years. Forty-nine patients underwent surgery for chronic cholecystitis or cholelithiasis, and 14 patients underwent surgery for acute cholecystitis. The remaining 28 patients underwent laparotomy for other reasons. Cholecystectomy was laparoscopic in 69 patients and open in 11 patients. The remaining 19 patients underwent various other surgical procedures such as autopsy, liver transplantation, living donor hepatectomy, Whipple procedure, and liver segment V resection. Histopathologically, hepatocellular carcinoma was detected in the ectopic liver tissue of one patient.

CONCLUSION

Ectopic liver tissue is a rare developmental anomaly which is usually detected incidentally. Although most studies suggest that ectopic liver located outside the gallbladder has a high risk of hepatocellular carcinoma, this is not reflected in statistical analysis.

Case report of ectopic hepatic tissue, a rare finding during a laparoscopic cholecystectomy

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Ectopic hepatic tissue is due to an uncommon failure of embryological liver development.

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Ectopic hepatic tissue attached to the gallbladder usually remains asymptomatic and is occasionally discovered during laparoscopy.

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In this case presented, the histopathological examination of specimen was confirmed to be ectopic liver tissue without hepatocellular carcinoma.

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It is important to be vigilant of ectopic hepatic tissue, because of their possible complication.

Introduction

Ectopic hepatic tissue is due to an uncommon failure of embryological liver development. The incidence of ectopic liver has been reported to be anywhere from 0.24% to 0.47% and a prevalence rate of 0.47% as diagnosed at laparotomy or laparoscopy. We report a case of Ectopic Hepatic tissue attached to the gallbladder wall that was discovered during a laparoscopic cholecystectomy.

Case report

A 47 year-old women presented to the surgery department with abdominal acute pain. The patient was taken for a standard laparoscopic cholecystectomy. The gallbladder was retracted cephalad while Hartmann’s pouch was retracted laterally. It was then noted that an ectopic tissue was present on the gallbladder wall. The patient recovered well after surgery, had no complications and was discharged the day after surgery.

Discussion

Ectopic hepatic tissue is a rare condition. The real incidence of ectopic hepatic tissue attached to the gallbladder wall is difficult to assess but is reportedly 0.24–0.47% of the population. Ectopic hepatic tissue attached to the gallbladder usually remains asymptomatic and is occasionally discovered during laparoscopy, as was the case with the patient in the present report. In this case presented, the histopathological examination of specimen was confirmed to be ectopic liver tissue without hepatocellular carcinoma.

Conclusion

It is important to be vigilant of ectopic hepatic tissue, their complications, and the potential surgical, including increased operative time and the need to follow up on such patients to rule out any possible complications.

Rare entity: Ectopic liver tissue in the wall of the gallbladder - A case report

Ectopic liver tissue (ELT) is a rare condition, which is usually not diagnosed preoperatively, but coincidentally during abdominal surgery. While the location of ELT can vary, it is usually localized on the gallbladder wall or in close proximity. ELT is associated with various complications, a major complication being extrahepatic hepatocellular carcinoma. A 59-year-old female underwent elective surgery for chronic cholecystitis with stones. During laparoscopic exploration, a 2-cm-diameter ELT was detected in the anterior gallbladder wall and a laparoscopic cholecystectomy was performed. The case is presented due to the rare nature of ELT and as a reminder of ELT-related complications.

Gallbladder-associated ectopic liver: A rare finding during a laparoscopic cholecystectomy

INTRODUCTION

Ectopic hepatic tissue is due to an uncommon failure of embryological liver development that is rarely described in the world medical literature. The incidence of ectopic liver (EL) has been reported to be anywhere from 0.24% to 0.47% as diagnosed at laparotomy or laparoscopy. We describe a case of EL adherent to the gallbladder, removed at laparoscopic cholecystectomy.

PRESENTATION OF CASE

A 37-year-old female was admitted for elective cholecystectomy having had an episode of acute cholecystitis provoked by gallstones. During the procedure, a 30mm×10mm×5mm section of EL tissue attached to the anterior wall of the gallbladder was identified and removed by en-bloc excision during laparoscopic cholecystectomy. Histological examination confirmed the absence of malignant degeneration of the hepatic tissue. The patient recovered well postoperatively and was discharged the day after the operation. She was well when seen six months later.

DISCUSSION

EL has been reported in several sites, such as the gallbladder, gastrohepatic ligament, adrenal glands, esophagus, and thoracic cavity. EL is often clinically silent and discovered incidentally during abdominal surgical procedures or autopsies. Because patients with ectopic liver may suffer complications such as torsion, peritoneal bleeding, fatty change, and evolution to cirrhosis or malignant degeneration to hepatocellular carcinoma, any ectopic liver tissue needs to be correctly identified and removed.

CONCLUSION

Despite the rare occurrence of EL, it should be recognized and removed by the surgeon to prevent a higher risk of complications and malignant transformation.